ObjectiveTo evaluate the economics of nafamostat mesylate compared with unfractionated heparin for continuous renal replacement therapy anticoagulation. MethodsA decision tree model was constructed to calculate the cost difference between the two anticoagulation methods. Survival analysis data comes from retrospective literature in Asian countries. The cost data comes from procurement data and the prices of medical and health services in some regions. A 72-hour scenario analysis is performed and a sensitivity analysis is performed on key parameters. ResultsThe basic analysis results showed that compared with the unfractionated heparin group, the total cost difference of nafamostat in the 144-hour CRRT treatment was 5 350.34 yuan, and the unfractionated heparin was more economical. In the 72-hour scenario analysis, unfractionated heparin is also more economical. Univariate sensitivity analysis showed that the cost of single-use hemodialysis filters and supporting pipelines and the cost of plasma antithrombin Ⅲ activity (AT-Ⅲ) measurement had a greater impact on the change of the cost difference. The results of probability sensitivity analysis show that the model structure is stable and robust. When the unit price of nafamostat is about 110.82 yuan/piece, the cost of nafamostat and unfractionated heparin in 144-hour CRRT treatment is both 19 185.37 yuan, and the cost difference is 0.ConclusionWhen the unit price of nafamostat mesylate drops to a sufficiently low level, it could have an advantageous health economy.
Objective To compare the costs of Danmu extract syrup and Xiaoer Chiqiao Qingre granules for the treatment of acute upper respiratory tract infection (AURI) in children. Methods We conducted this prospective cohort study from July 2018 to June 2020. Children with AURI in the pediatric outpatient department and emergency department of West China Second Hospital were enrolled, and were divided into two groups: Danmu extract syrup group (Danmu group) and Xiaoer Chiqiao Qingre granule group (Chiqiao group) according to the treatment. The pharmacoeconomic evaluation took the medical and health system as the research perspective and considered direct medical costs, including registration fees, drug fees, inspection fees, testing fees, and treatment fees. A cost-effectiveness analysis or a cost minimization analysis was adopted according to the results of efficacy between the two groups. Results We enrolled 1 036 children with AURI. After propensity score matching, 252 in the Danmu group and 253 in the Chiqiao group were included. There was no statistically significant difference in the symptom recovery time between the two groups. The cost minimization analysis showed that the total costs (median difference −21.55) and drug costs (median difference −7.24) of the Danmu group were significantly lower than those of the Chiqiao group (P<0.001). The results of the subgroup and sensitivity analyses were consistent with the primary analysis. Conclusion Danmu extract syrup is a cost-saving alternative compared with Chiqiao granules for AURI in children.